Congenital heart disease occurs in the population with a frequency of 8 per 1000 live births. Information on the incidence of various congenital heart defects in newborns in connection with the widespread introduction of prenatal ultrasound diagnostics and an increase in its accuracy allows for planning pregnancy and management of newborns with critical heart defects. The aim of this study wasto retrospectively study the incidence of various congenital heart defects according to echocardiographic studies among newborns in the framework of the experience of one clinic over the period from 2009 to 2019. In the clinic of the Science Research Institute of Cardiology, echocardiographic studies were performed in 34298 children aged 1 day to 17 years, the average age was 3.68 years, the median 2.0 years. The newborns accounted for 4.6% of them (n = 1607). The results of echocardiographic studies were analyzed in 1607 newborns aged from 1 to 27 days. In 247 (15.3%) of the examined no congenital defects were detected, 1360 newborns had various congenital heart diseases. It was found that the most common anomaly in newborns were interventricular septal defects (37%), more than 60% of all interventricular septal defects were clinically insignificant small muscle defects. It has been shown that the incidence of congenital heart defects in newborns with complex prenatal diagnosis (coarctation of the aorta, double outlet right ventricle) has increased in recent years. A decrease in the incidence of atrioventricular septal defect was observed over the past five years. The possibilities of neonatal cardiac surgery in a particular clinic influenced the structure of the occurrence of individual congenital heart disease due to prenatal pregnancy planning and surgical tactics.

Aim . To evaluate the informational and diagnostic significance of the myocardial Tei index. Patients and methods . The study assessed data of echocardiographic studies of 9,256 patients aged 1 month to 60 years, 1,350 healthy individuals, and 7,906 patients with various cardiovascular diseases with abnormal volume-capacitive characteristics of the heart (congenital heart defects, different types of cardiopathy, and hypertensive disease). Results . The cutting points of the normal values of the indicator were established. Data showed that the Tei index did not reflect changes in the pumping function of the left ventricle and did not depend on the contractility of the left ventricle (LV), but it had direct significant correlation with the left ventricular filling pressure, both in normal and pathological conditions. Correlation was more significant in adult patients. Conclusion . Normal values of the Tei index less than 0.5 were observed in more than 95% of practically healthy individuals of any age. The maximum sensitivity and specificity of the myocardial performance index was found in patients with restrictive and dilated cardiopathy and common atrioventricular connection.

The study centered on the possibility of surgery on the atrial septum (AS) without aortic clamping and cardiac arrest. We compared two groups of patients who underwent intervention on AS as the major or concomitant stage of surgical treatment. Nineteen patients were assigned to the main group; they were operated under CPB without aortic clamping and cardioplegia. The control group consisted of 20 patients, whose AS was surgically treated by using a standard technique with aortic occlusion. The groups were comparable by age and disease. The patients of both groups withstood the surgical interventions satisfactorily, with no mortality. The mean CBP time in the patients operated without aortic clamping was shorter than that in the control group patients (operated with aortic clamping) by about 18-20 minutes. The major surgical stage time did not differ between the groups. The technique of atrial septal defect closure or its dissection on the beating heart without cardioplegia is safe, comfortable for a surgeon and allows saving time required for the recovery period. Besides, it does not cause myocardial lesion associated with cardioplegia.

The review analyzes literature data on the phenomenon of chronic heart failure as a clinical syndrome of hypoperfusion of organs and systems of the body due to multiple causes of pumping inadequacy of the circulatory system. Special attention is paid to diastolic heart failure of different origin. Attention is drawn to the fact that integrated quantitative characteristic of CHF of any origin is indexed cardiac output (CO) rather than ejection fraction, and that allocation of systolic and diastolic CHF is a relatively conventional division concept. It has been shown that in heart failure of any origin, cardiac output is reduced, resulting in diminished supply of oxygen and substrates to tissues of the body. The variety of causes of heart failure with preserved ejection fraction makes it impossible to correct hemodynamic disturbances by "standard set" of drugs. Normalization of the balance between delivery of oxygen / substrates and metabolic demands of tissues may be a key approach to the treatment of diastolic heart failure of different origin.

The analysis of a 6-year patient’s medical history after correction of congenital heart disease (partial anomalous drainage of the right superior pulmonary vein into the superior vena cava) complicated by obstruction of the anastomosis between the SVC and the appendage right atrium is presented. The article discusses the stages of diagnosis and patient management features, as well as the choice of treatment.Received 12 December 2016. Accepted 14 February 2017.Financing: The study did not have sponsorship.Conflict of interest: The authors declare no conflict of interest.Svyazov E.A.: data analysis, article writing and editing. Podoksenov A.U.: article editing. Varvarenko V.I.: implantation of the stent-graft in superior vena cava.Martsinkevich G.I.: echocardiographic examination of the patient before and after endograft implantation, article editing. Krivoshchyokov E.V.: organizational work and referral of the patient to endovascular treatment, article editing.

The analysis of echocardiography results in 394 fetuses and 570 neonates showed the high accuracy of prenatal diagnosis of congenital heart disease (CHD) in a specialized cardiac surgery facihty. The accuracy of critical CHD identification at the unspeciahzed stage of fetal diagnosis was 50%. Heart defects, such as aortic coarctation, interrupted aortic arch, and total anomalous pulmonary venous drainage, turned out to be most difficult for prenatal diagnosis (at all stages). There were no problems in the prenatal diagnosis of the following defects: tetralogy of Fallot, all types of single ventricle defect, and atrioventricular septal defect. The discordances between the diagnosis of CHD by fetal echocardiography at an obstetric stage and that in a specialized cardiology facihty were mostly due to the inaccurate description of all components of complex heart defects.

The analysis of echocardiography results in 394 fetuses and 570 neonates showed the high accuracy of prenatal diagnosis of congenital heart disease (CHD) in a specialized cardiac surgery facihty. The accuracy of critical CHD identification at the unspeciahzed stage of fetal diagnosis was 50%. Heart defects, such as aortic coarctation, interrupted aortic arch, and total anomalous pulmonary venous drainage, turned out to be most difficult for prenatal diagnosis (at all stages). There were no problems in the prenatal diagnosis of the following defects: tetralogy of Fallot, all types of single ventricle defect, and atrioventricular septal defect. The discordances between the diagnosis of CHD by fetal echocardiography at an obstetric stage and that in a specialized cardiology facihty were mostly due to the inaccurate description of all components of complex heart defects.

The present study investigates the phenomenon of the early postoperative left ventricular (LV) remodeling in children of the first year of life after radial correction of interventricular nonrestrictive defects. Based on dynamic evaluation of the heart chamber volumes and LV wall thickness in children of different age, it has been shown that a sharp decrease in postoperative LV volume was more common in children of the first year of life. Postoperative LV remodeling was encountered in 58% of infants and in 39% of older children. Increased left ventricular wall thickness in the early postoperative period was the main cause of diastolic heart failure which manifested hemodynamically as reduced cardiac index with preserved normal LV ejection fraction. Heart remodeling occurred more often in children with underweight and growth impairment. It has been found that a decrease in left atrial volume (relatively to the proper values) before surgery increased the risk of the early LV remodeling. Children with ventricular septal defect (VSD) without significant increase in left ventricular volume (less than 160% of proper values) and the preservation of the normal diameter of the truncus have substantially higher risk of early postoperative heart remodeling.

To study the asynchrony phenomenon, 100 pediatric patients aged 3 15 years with secondary inter atrial septal defects, 100 pediatric patients with different congenital heart diseases (Fallot’s tetralogy, patent ductus arteriosus, coarctation of aorta, and aortic stenosis), and 30 children free of congenital heart diseases were examined.

The purpose of the present investigation was evaluation the diagnostic possibilities of one-dimensional, two-dimensional and three-dimensional echocardiography in healthy children of different age, and also estimation of possibilities of individual forecasting parameters of echocardiography in change of anthropometrical data. On the basis of echo examination of 2650 children at the from 1 day till 18 years the equations of linear regression allowing with accuracy of 80-97 % to carry out individual forecasting of values of volume and linear indicators of two-dimensional echocardiography with the use of anthropometrical data have been defined. It is shown, that use of the M-regime echocardiography is unacceptable for scoping of left ventricle is absolutely unacceptably in children at the till 6 months, it is undesirable for children at the till 7 years and gives an error to 124 %. In children aged till 6 months left ventricle was increased on a long axis and is less spheric in comparison with the senior groups. It is established, that normative values end diastolic volume of the left ventricle (EDV) in children are not constant and increase twice at the of 1-2 years in comparison with children who have not reached the of 1 month. The long-term dynamic estimation of volumes of chambers of heart, the linear sizes and diameters of large vessels in children should be carried out not by use of age norms», and with application of anthropometrical specifications. It is shown that use of five-chamber position of the image of left ventricle in children does not concede on accuracy to Simpson's two-projective method.

On 35 supervision the efficiency of the cardio-resynchronizing therapy and frequency of irregular rhythm at patients with heart insufficiency were studied. The conclusion is that the implantation of the bi-ventricular cardiostimulators with function of the cardioversion-defibrillation is indicated to the patients with the severe heart insufficiency and ventricular dissinchronia with the purpose of primary prophylaxis of sudden death. In authors opinion to determine the pro-aritmogenic influence of the cardio-resynchronizing therapy the further researches are necessary.

To assess the effectiveness of cardioresynchronizing treatment and incidence of ventricular arrhythmias in patients with heart failure refractory to medical treatment (functional classes III IV according to NYHA classification) and ventricular dyssynchronism, 35 patients (11 females and 24 males) aged 42 68 years (mean 58.3±14.4 years) with coronary artery disease and dilated cardiomyopathy were followed up.

To evaluate the dynamics of cardiac output in the course of changes in pacing regimes using the integral of circulation in the right carotid artery and such ultrasound indices as: indices of intra- and inter-ventricular dyssynchrony, index of mechanic delay, the left ventricular ejection fraction, and others, twelve patients with chronic heart failure of functional classes III-IV (NYHA) in whom the resynchronizing treatment was performed were followed-up.

Brachial artery blood flow reactions to hyperemia and hyperventilation (endothelium dependent vasodilation and vasoconstriction) were studied by doppler sonography in patients with ischemic heart disease and 87 persons aged 12-39 years with family history of atherosclerosis. Reactivity of peripheral artery and risk factors of atherosclerosis development were foun to be interrelated. The results allowed to suggest participation of atherogenic fractions of lipoproteins, proinflammatory cytokines, and monocyte derived NO in formation of pathological vascular reactions in persons with family history of atherosclerosis.

The research is devoted to the evaluation of the depressor and constrictive components of the vascular reactiveness in the people with burdened heredity on atherosclerosis and the factors of risk of this disease’s development. The connection of the vascular reactiveness of peripheral arteries with the factors of risk of atherosclerosis development is discovered. The results of researches allow to suppose that atherogenic factions of lipoproteins, inflammatory cytokines produced by mononuclear of nitric oxide participate in the formation of pathological vascular reactions in people with atherosclerosis and with burdened atherosclerosis heredity on preclinical disease level.